合并先天性核性白内障的晶状体内圆锥一例

Anterior internal lenticonus accompanied by congenital nuclear cataract: a case report and literature review

Purpose: To report the clinical characteristics and surgical findings of a rare case of anterior internal lenticonus accompanied by congenital nuclear cataract. Methods: The patient was examined by complete ophthalmologic and systemic examinations followed by manual small incision extracapsular cataract extraction in the right eye. Literature regarding this rare condition was also reviewed. Results: Ocular examination showed the cortex and adult nucleus of lens were clear, yet the infant and fetal nucleus were opacified with increasing severity in the right eye. The anterior surface of the fetal nucleus was conically protruded and nearly contacted with the adult nucleus, yet the contour of anterior capsule was normal. During cataract extraction, no fragibility of anterior capsule was found, and a chalk-like fibrotic core nucleus with a conus of anterior surface was found after nucleus was prolapsed from the right eye. Preoperative and postoperative visual acuity was counting fingers and 20/32, respectively. Literature search revealed that there were only five cases of internal lenticonus reported before and no definitive cases were accompanied by congenital nuclear cataract. Conclusions: We firstly reported a rare case of anterior internal lenticonus accompanied by congenital nuclear cataract. Viral infection during embryonal and fetal period might account for the formation of anterior internal lenticonus and congenital nuclear cataract in this case. Cataract extraction could successfully performed in internal lenticonus cases and got a good visual outcome.